USF-COM
Department
of Family Medicine
Patient Education Information on...
Index of
Patient Education Topics
What is asthma?
Asthma is a disorder affecting the lungs which involves chronic inflammation
and hyperresponsiveness of small airway passages within the lung.
Inflammation is a process in which a large number of blood cells of the
immune system travel to the airways and release chemical factors which
bring about many changes. This occurs for different reasons in different
patients: certain factors trigger this reaction. Airways become
inflamed and swollen- thus narrow and/or blocked.
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How common is asthma?
About 10 million people in the United States have asthma. However,
4000-5000 people die annually from asthma complications. It is currently
the leading serious chronic illness of children in the United States.
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How do I know if my child has asthma?
Asthma typically presents in people with wheezing, shortness of breath,
rapid breathing, and cough. Often, patients describe attacks as a
sensation similar to breathing through a straw.
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What causes asthma attacks?
Why children (or adults) develop asthma is not fully understood though
there has been much research in this area. It is believed that there
is a genetic component that may be inherited, perhaps more so from the
mother’s blood line. Also, it is appearing more likely that pregnant mothers
who smoke cigarettes more often give birth to asthmatic children.
Triggers that induce attacks include viral infections and panic attacks,
but more commonly exercise or environmental factors. These factors
include mold, pollen, dust, animal dander, cigarette smoke (direct or side-smoke),
certain food additives, and medications such as aspirin and b-blockers.
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How will my doctor know if my child has asthma?
Without these triggers, often patients do not exhibit any signs that they
have asthma and are without symptoms. However, during an attack,
the patient’s description of the symptoms and the doctor’s exam of the
lungs usually reveal the diagnosis. In addition, other tests are
used by physicians. Pulmonary function tests are often used to measure
the amount of air a patient can forcefully exhale in 1 second. If
stimulators decrease this amount by 15% or use of therapeutic inhalers
increases it by 15%, the test supports the diagnosis and can judge the
severity. Occasionally, chest x-rays are taken to rule out other
causes of lung symptoms, such as heart disease.
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What can be done about asthma?
Asthma cannot be cured, but it can be well controlled using medications.
Bronchodilators are inhalers which can be used during attacks to relax
and open up airways to allow your child to breathe more easily. Anti-inflammatory
drugs are taken long term in more serious cases of atom (in addition to
bronchodilators for any attacks) to prevent attacks from occurring.
These drugs work by preventing immune cell function or release of chemical
factors. Cromolyn and corticosteroids are examples.
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Aren’t inhalers and steroids dangerous?
Bronchodilators are relatively harmless when taken as prescribed, in moderation.
These drugs are structured to only affect the lungs and not the rest of
the body, except when used in excess. Steroids used in asthma are
inhaled forms which only affect the lungs and are completely different
from steroids abused by athletes. However, all drugs have side effects.
If you notice sore throat, nervousness, nausea, rapid heartbeat, loss of
appetite, or inability to sleep, contact your doctor. Your child’s
dosage may need to be altered or another medication used.
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What else can I do to avoid attacks?
Extremes in climate can induce attacks. High humidity causes an increase
in pollen and mold production. Also, cold air can trigger an attack.
Staying indoors when weather is poor and using filtered air conditioning
and heating is helpful. Avoiding cigarette smoke is extremely important.
Finally, dust and animal dander must be cleared from the home routinely,
especially the bedroom. Unfortunately, sometimes pets are incompatible
with asthmatic children.
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What should I worry about during an attack?
If symptoms worsen, even 15 minutes after use of a bronchodilator, this
may indicate a severe attack. Major airways can become blocked, the
patient could suffocate. If the child’s chest and neck are sucked
in with each breath, shoulders are hunched or being lifted with each breath,
the child is unable to walk or talk, or if lips or fingernails turn gray
or blue, GO IMMEDIATELY TO THE EMERGENCY ROOM!
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References
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Doull I, Holgate S. Asthma: early predisposing factors.
British Medical Bulletin. 1997. 53(1):71-80.
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Barnes P. Current Therapies for Asthma. Chest. 1997.
111(2):17S-26S.
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Taylor, R. Fundamentals of Family Medicine. New York:
Springer, 1996.